Thursday, April 15, 2010

Help a dead baby family convince insurance they were "enhanced & protected."

On April 17th, 2009, we found out Joel might have a health condition. Then we were told it'd all be fine. Then he died a few weeks later. It sucked. Alot. Coming up on the 1 year mark of everything that happens, well, sucks in it's own way. I should be planning a birthday party, not dealing with all of this crap.

I'm asking for a favor. Yeah, another.

As I've talked about, since Joel died, I've had to deal with lots of crap. Crap from doctors, crap from hospital, & crap from insurance. Every battle has been settled, except for this battle with insurance that I've been fighting for months. Basically, they don't want to pay Joel related bills. Just because. I've submitted, I've called, I've complained. I talk to people on the phone & have to have a 5 minute discussion first about if I delivered a baby in May 2009 or not. That's always fun. I've appealed. I've written professional, smart sounding letters about my son dying & used technical terms for unimaginable things done to his body during the autopsy, which they also refuse to pay for. They've refused to pay for blood testing to find out if any disorders could have contributed to his death that we could prevent in the future. They even refuse to pay for basic services they usually do with a delivery...like someone visually looking at my placenta after delivery. We were charged like $400 for that honor.

Simply put, they are the perfect example of why some people hate insurance companies & think they are the devil.

Today we received what is our next to last response, meaning we only have 1 appeal left before the matter is considered done & over with & we're left with debt up to our eyeballs. Also, another fun fact is that since it'd been 6 weeks & I was suppose to get an answer within 4, I called the insurance company at 4:30pm last Thursday (the 8th) & was told they still had no idea what they were doing & it'd be a few more weeks for a decision. The rejection letter I got? Dated for April 8th, the same day I called. Some how that get on my nerves.

The verdict? They have the deepest, sincere sympathies for Mrs. Culiver (Um, that isn't my name), but they aren't paying for any of it based on the fact that none of it "would protect or enhance any current person on the policy." Meaning us living folks.

Finding out if could have had Joel some rare disorder that Jules may have or pass onto his kids that we just didn't know about yet...not enhancing or protective.

Finding out that we have a high chance of this happening again so maybe we shouldn't get pregnant again...not enhancing or protective.

Keeping me from going through hours of labor to produce yet another dead baby because we didn't know what caused Joel to die could happen again....not enhancing or protective.

Apparently, it's all pointless in their eyes. None of it was done for any reason I guess.

Something about that is more offensive to me than just telling me, "sorry, we don't cover dead babies." I sure didn't opt to testing & an autopsy to bring Joel back from the dead. I did it so I wouldn't want to slit my wrist because I may have done something wrong. I did it to make sure I didn't get pregnant & have to look at my husband again when they told us our baby was dead. I did it so Jules wouldn't have a lifetime of wondering if his kids would all die, too, if maybe he was the fluke here for living. To say it wasn't going to enhance or protect anyone, quite frankly, is bullshit.

I'm obviously dealing with people who've not had term stillbirths, which is great for them because no one deserves that shit, for them to tell me that everything was basically pointless & that I guess we should have had him them just went home like nothing was wrong. Gee, I wish I knew that BEFORE I had to go on medication to try to cope with daily life.

Last time I faced something like this, an insane amount of people stood up & helped me out by contacting a hospital that was refusing to give me a bill to even try to get insurance to pay me back. After everyone contacted the hospital, I had a bill fed-ex'ed to my house the next day. I'd link to the story, but I'm fired up right now & can't do anything but this at the moment.

I have 60 days before I have to submit my last appeal attempt & I would like some help. I'm suppose to submit "evidence" that their decision is wrong. Since insurance is saying the entire reason they aren't paying a cent is because they think everything done wasn't to attempt to "enhance & protect" people involved, I'd like them to hear from others, not just me since I'm biased in their eyes. Be it people who just care & know that for us it WAS enhancing or protecting to try to find out what happened with Joel, or people who've been in this awful situation themselves & know that trying to find out what happened or if it can be prevented in the future did enhancing & protective things for themselves.

If you or anyone else would like to make my appeal have to be delivered in a package instead of a small, basic envelope, or you'd just like to share your anger at my insurance company, I will gladly accept letters of support of us or hate for them to submit as evidence in my claim. Whatever stance you rather take is fine.

I'm asking that by May 20th, Joel's due date, people help me gather evidence that testing & such should be covered, as it was to protect & enhance us, the living people on the policy. If you'd like to write a quick letter or a long essay for me to use as evidence as to why exams, testing, etc. was to in fact protect & enhance usnow & in the future, please feel free to submit it to me...

Evidence for the Culver Family
PO Box 73
Huntington, WV
25706

Oooohhhh...it's my mailing address! I'd offer to let you email it, but I figure something with a fancy, real life signature would look better. I'd also direct you straight to my insurance company, but they can't even spell my name right so heaven knows it'd just get lost in the shuffle of stupid people in an office, so I plan on sending everything all together in one big package.

Please feel free to spread the word about this, tell you friends, share this link, whatever that will add a couple pieces of paper to my stack. I, of course, will explore avenues in my little part of the world to get this out as well. Though I don't hold much hope for the news or anything, as I'm fighting the state employee insurance agency that is untouchable it seems.

I'm off to stew some more & try to spread the word. If you happen to spread the word on your own blog or anywhere else & would like me to list it, feel free to let me know & I'll add a link to a list.

Edit...

Mel made a facebook group for this effort if you're interested in keep tabs.

Kudos go out to Mel from Lost & Found Connections Abound for adding this effort to the daily new post.

Thanks to the baby loss peeps & peeps in general for caring & helping us out.

11 comments:

  1. Not too long ago a couple of segments aired on The Today Show regarding insurance companies denying coverage for stupid "reasons." The story that I remember was about an infant in Colorado that was denied coverage for being "obese." People were outraged that an infant could be considered obese! A couple weeks after the segment aired there was an update that the insurance company changed their policies and covered the infant. Maybe you could contact the Today Show and see if they could help, if your local news is not interested?

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  2. This is always so frustrating for me because I work for an insurance company. Jess, do you have any of the codes that were billed to the insurance company? I am curious as to if its something we would have covered. We didn't do an autopsy for Jonathan, but we did pathology on his placenta and that was covered. Did your insurance deny that? Am I understanding this? Feel free to email me or facebook me. *hugs* Not sure I can help, but lets chat.

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  3. Oh, honey, I'm so sorry to hear about this. I found you via Aunt Becky, and a letter is on its way to you today. I'm so sorry, and so proud of your strength and vulnerability and ability to share. Everything you are going through sucks and I wish I could give you a hug and then pour you a stiff drink. I have no words for this insurance company - not that are suitable for polite company.

    xoxo
    *jen

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  4. Wow, as if having a child at term and having them pass isn't devastating enough. I'm terribly sorry for the loss of Joel, I can't fathom how painful and life shattering that must have been and I'm sure, continues to be, for you and your husband. I've never been in your situation, so I don't know that a letter from me would amount to much, but I'm going to send one off tomorrow in the hopes that this issue will be resolved and allow you to move on to other aspects of your life that I'm sure deserve more attention than this ridiculous insurance company.
    You're in my thoughts and prayers-and thanks to Aunt Becky for alerting me to this blog.
    My best,
    Agape

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  5. First of all, I'm very sorry for your loss.

    My suggestion is to contact anyone and everyone who had anything to do with you, your pregnancy and the baby. Make them write letters as well (if you haven't already done so). Sometime insurance companies want that medical jargon from a doctor, therapist, nurse, etc. Good luck, and God bless.

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  6. I am appalled at the way you and your family is being treated! I get insurance companies are business, but they still deal with PEOPLE! They need to be compassionate. I will write a letter for you and for your family. They can NOT be allowed to get away with this!
    Sending you SO much peace and love to get through this whole ordeal.
    *HUGS*

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  7. Would it help if I wrote a nasty and grumpy letter telling them that all of this is covered in the Canadian Medical System, you know the system that they keep telling American's is completely substandard to their much better private system? Cause I will, very happily.

    I'm so sorry that this has happened to you.

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  8. Jess, I don't have the codes in front of me, but I can get them together. I'll send them to you to let you see what you guys would have done. I have a big folder of anger with everything together. I appreciate any feedback you can give me.

    And for the record, the husband & I have threatened to move to Canada for years now. Sad thing to me is that this is the state employees health care...suppose to be one of the best you can get in the state. The "best" sure hasn't gotten me very far. I'm angry that they paid the doctor a delivery fee (like $1300), a doctor who didn't deliver my baby. He stood in the room & gave permission to someone who had no privileges in the hospital to catch the baby & signed off like he did it himself so he could bill for it. He should donate some of that money to this cause in my opinion, but whatever.

    Anyway, I want to thank everyone for the support & suggestions. It makes me feel better...I'm always questioning myself like "this is a big deal, right?" I just find it so hard to believe I've been denied because nothing about it would benefit any existing person. I've not written my own letter yet because I'm trying to piece together my thoughts. But I'm likely going to pose the question of "how many dead babies would you like me to have before it's suppose to impact me? I'd like a number, just so I can know." Of course, they've already told me to cover the blood testing I'd have to have 3 stillborn babies. Not three miscarriages or something happening to cause labor early or something happening in labor & delivery, but 3 babies die in the womb & have to be delivered. THREE?! It's amazing I didn't kill myself after that once, I don't have much hope if there is a 2nd. Maybe that's what they are counting on.

    Anyway, it's late but I just wanted to say thanks for the comments & to anyone who has shared & will share this story in the near future.

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  9. Have you contacted your state Department of Insurance (http://www.wvinsurance.gov/) or if it is a policy under ERISA (employees retirement income securities act) then have you contacted the U.S. Department of Labor? You want to do so soon and make sure your insurance company knows you are reporting them.

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  10. Contact your Senators and Congressman asap. They've been focused on the mine tragedy, but they have staffs that can help with this. You'll need to work quickly to get a disclosure form, but this is absolutely worth doing.

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  11. Helllo,
    I am late here- but directed from Aunt Becky's page and- if you can believe it- writing you from Charleston, WV- so very close to you. I am so sorry for your loss. Nothing anyone says can make a difference- but I'll say it none the less. I lost our second child this past Nov. at 19 weeks- I know that nothing makes it better. I am writing a letter right now because I am so irate at this crap and I would like to know who your insurance is because that is all kinds of bullshit and I am so angry for you. I could not imagine having to deal with this- thankfully our insurance paid for everything and never made a peep, which is good because I would have injured someone.

    Anyway, I also want to leave you with my email because I am right down the road, and if you need someone to talk to I can literally be a person in front of you in 30 minutes (I drive fast). also I am not a crazy stalker person or anything- just another momma who lives close by.

    my email: mountainmomma18@gmail.com
    My name is Jessica

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